摘要
目的探讨信迪利单抗引起免疫治疗相关性肝损害及血小板减少原因、处理方法及药学监护,保证患者免疫治疗安全有效。方法临床药师全程参与信迪利单抗致免疫治疗相关性肝损害及血小板减少治疗过程,从不良反应发生鉴别、机制、处理方法及后续治疗方案等方面进行分析,并提供药学监护。结果信迪利单抗可引起免疫治疗相关性肝损害及血小板减少,尽管免疫治疗不良反应发生率较低,但应对接受免疫治疗且存在潜在抗肿瘤治疗风险的患者及时进行基线评估,做好患者疾病相关危险因素的管理,配合临床医生进行相关疾病的评估、干预和治疗,降低肿瘤患者不良反应的预后风险。结论临床药师主动监测并参与肿瘤免疫治疗相关性血液毒性及肝毒性等不良反应分析、药学监护及治疗方案分析,可降低肿瘤不良反应预后风险,为临床行免疫治疗患者提供用药参考及指导,有效提高患者药物治疗的有效性及安全性。
Objective To investigate the causes,treatment and pharmaceutical care of immunotherapy-related liver injury and thrombocytopenia caused by sintilimab,and to ensure the safety and effectiveness of immunotherapy in patients.Methods Clinical pharmacists participated in the whole process of treatment of immunotherapy related liver injury and thrombocytopenia induced by sintilimab,analyzed the identification,mechanism,treatment methods and subsequent treatment options of adverse reactions,and provided pharmaceutical care.Results Sintilimab could induce immunotherapy-related liver injury and thrombocytopenia.Although the incidence of adverse reactions of immunotherapy is low,we should timely perform baseline assessment for patients receiving immunotherapy and at potential risk of anti-tumor treatment,while doing a good job in the management of disease-related risk factors,and cooperate with clinicians in the assessment,intervention and treatment of related diseases.The above measures can reduce the prognostic risk of adverse reactions in cancer patients.Conclusion Clinical pharmacists actively monitor and participate in the analysis of adverse reactions such as hematotoxicity and hepatotoxicity associated with cancer immunotherapy.By giving pharmaceutical care and treatment plan analysis,it can reduce the risk of prognosis of adverse tumor reactions,provide medication reference and guidance for patients undergoing clinical immunotherapy,and effectively improve the effectiveness and safety of drug treatment for patients.
作者
谢希晖
王学芳
张玲
马玉婷
刘静
XIE Xi-hui;WANG Xue-fang;ZHANG Ling(Dept.of Pharmacy,Jiuquan People’s Hospital,Jiuquan 735000,China.)
出处
《中国处方药》
2024年第4期78-81,共4页
Journal of China Prescription Drug
基金
酒泉市民生科技计划项目A类(2022MA10350)。
关键词
信迪利单抗
免疫治疗
肝损害
血小板减少
Sintilimab
Immunotherapy
Hepatic impairment
Thrombocytopenia
